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General NPI Number Information
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NPI Number | 1992040927
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTH CHIROPRACTIC & REHABILITATION, INC
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 233 S WACKER DR LL1-054
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City | CHICAGO
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State | IL
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Zip | 60606-7147
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Country | US
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Telephone | 312-879-1979
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Fax |
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Provider Business Mailing Address
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Address Line | 233 S WACKER DR LL1-054
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City | CHICAGO
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State | IL
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Zip | 60606-7147
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Country | US
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Telephone | 312-879-1979
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. ERIC SMITH
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Credential | D.C.
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Telephone | 312-879-1979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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